Oral Healthcare Education, Equity and Policy Implementation in Rural Honduran Communities

Rural Honduras encompasses many individuals with limited access to a dental professional. Many public health studies demonstrate that dental shortage areas have more dental cavities, missing teeth, and more complex restorations that need periodic treatment. Dental hygiene is undermined at home with limited access to oral health advocates, and dental education becomes more essential. Here, we report an educational consensus and perspectives of rural Honduras through a questionnaire distributed at 13 mobile dental clinics in remote villages. To assess the effectiveness of education, the World Health Organization (WHO) has deemed two important indices in assessing trends: Community Periodontal Index of Treatment Needs (CPITN) and Decayed, Missing due to caries and Filled Teeth (DMFT). These two previous indices are reported and discussed to determine the importance of future research trends that need to be made to assess the effectiveness of future education and policy implementation. Finally, we look at barriers to dental access to analyze different forces that are detrimental to rural Hondurans to offer policy implementation to the nation\u27s current business model of healthcare. Eight hundred seventy-three patients who visited the clinics were screened, and 502 individuals were asked to answer the questionnaire from the set of parameters. Of the 220 participants who answered the questionnaire, every respondent deemed finding a dentist difficult, with 160 (73%) claiming they had not visited a dentist in the past two years. This demonstrated a need to increase access to the rural Honduras population of dental professionals. Of the respondents who had not seen a dentist in the past two years, the at-home hygiene education was statistically different from the 60 who had seen a dentist in the last two years, demonstrating a further need to increase education on dental cleaning within the rural area Honduras population. The indices reviewed were not sufficient to provide current statistical measures on the nation’s dental health, resulting in a need to procure future research on the state of rural Honduras’s dental health. Lastly, policy analysis found that educational, financial, infrastructural, technological, and accountability standards must be reviewed through changing policies to improve limited access for rural Hondurans

Black hole variability and the star formation-active galactic nucleus connection : do all star-forming galaxies host an active galactic nucleus?

We investigate the effect of active galactic nucleus (AGN) variability on the observed connection between star formation and black hole accretion in extragalactic surveys. Recent studies have reported relatively weak correlations between observed AGN luminosities and the properties of AGN hosts, which has been interpreted to imply that there is no direct connection between AGN activity and star formation. However, AGNs may be expected to vary significantly on a wide range of timescales (from hours to Myr) that are far shorter than the typical timescale for star formation (gsim100 Myr). This variability can have important consequences for observed correlations. We present a simple model in which all star-forming galaxies host an AGN when averaged over ~100 Myr timescales, with long-term average AGN accretion rates that are perfectly correlated with the star formation rate (SFR). We show that reasonable prescriptions for AGN variability reproduce the observed weak correlations between SFR and L AGN in typical AGN host galaxies, as well as the general trends in the observed AGN luminosity functions, merger fractions, and measurements of the average AGN luminosity as a function of SFR. These results imply that there may be a tight connection between AGN activity and SFR over galaxy evolution timescales, and that the apparent similarities in rest-frame colors, merger rates, and clustering of AGNs compared to "inactive" galaxies may be due primarily to AGN variability. The results provide motivation for future deep, wide extragalactic surveys that can measure the distribution of AGN accretion rates as a function of SFR

The complexity of linear-time temporal logic over the class of ordinals

We consider the temporal logic with since and until modalities. This temporal logic is expressively equivalent over the class of ordinals to first-order logic by Kamp's theorem. We show that it has a PSPACE-complete satisfiability problem over the class of ordinals. Among the consequences of our proof, we show that given the code of some countable ordinal alpha and a formula, we can decide in PSPACE whether the formula has a model over alpha. In order to show these results, we introduce a class of simple ordinal automata, as expressive as B\"uchi ordinal automata. The PSPACE upper bound for the satisfiability problem of the temporal logic is obtained through a reduction to the nonemptiness problem for the simple ordinal automata.Comment: Accepted for publication in LMC

Misconceptions in water resource studies

During the following years civil engineers, hydrologists and mathematicians were unable to determine the cause of these anomalies. Now, here in South Africa, as well as in many other countries with dry climates, the demand already exceeds the available secure water supplies from many river systems.http://www.civils.org.za/am201

Thermodynamic relations in a driven lattice gas: numerical exprements

We explore thermodynamic relations in non-equilibrium steady states with numerical experiments on a driven lattice gas. After operationally defining the pressure and chemical potential in the driven lattice gas, we confirm numerically the validity of the integrability condition (the Maxwell relation) for the two quantities whose values differ from those for an equilibrium system. This implies that a free energy function can be constructed for the non-equilibrium steady state that we consider. We also investigate a fluctuation relation associated with this free energy function. Our result suggests that the compressibility can be expressed in terms of density fluctuations even in non-equilibrium steady states.Comment: 4 pages, 4 figure

Super black hole as spinning particle: Supersymmetric baglike core

We consider particlelike solutions to supergravity based on the Kerr-Newman black hole (BH) solution. The BH singularity is regularized by means of a phase transition to a new vacuum state near the core region confining a dual gauge field. Supersymmetric BPS-saturated domain wall model is suggested which can provide this phase transition and formation the stable charged superconducting core. For spinning particle the core takes the form of thin, relativistically rotaiting disk.Comment: 9 pages, Latex, plenary talks given at the School-Workshop Praha-Spin-2001 (Prague,July 15-28,2001) and at the XXIV International Workshop on Fundamental Problems of HEP and Field Theory (IHEP, June 2001, Protvino

Cost‐effectiveness of Anti‐CD19 chimeric antigen receptor T‐Cell therapy in pediatric relapsed/refractory B‐cell acute lymphoblastic leukemia. A societal view

Introduction: In several studies, the chimeric antigen receptor T-cell therapy tisagenlecleucel demonstrated encouraging rates of remission and lasting survival benefits in pediatric patients with relapsed/refractory (r/r) acute lymphoblastic leukemia (ALL). We assessed the cost-effectiveness of tisagenlecleucel (list price: 320 000 EUR) among these patients when compared to clofarabine monotherapy (Clo-M), clofarabine combination therapy (Clo-C), and blinatumomab (Blina) from both a healthcare and a societal perspective. We also assessed future medical and future non-medical consumption costs. Methods: A three-state partitioned survival model was used to simulate a cohort of pediatric patients (12 years of age) through different disease states until the end of life (lifetime horizon). Relevant outcomes were life years, quality-adjusted life years (QALYs), healthcare costs, societal costs, and the incremental cost-effectiveness ratio (ICER). Uncertainty was explored through deterministic and probabilistic sensitivity analyses as well as through several scenario analyzes. Results: Total discounted costs for tisagenlecleucel were 552 679 EUR from a societal perspective, which was much higher than the total discounted costs from a healthcare perspective (ie, 409 563 EUR). Total discounted societal costs for the comparator regimens ranged between 160 803 EUR for Clo-M and 267 259 EUR for Blina. Highest QALYs were estimated for tisagenlecleucel (11.26), followed by Blina (2.25), Clo-C (1.70) and Clo-M (0.74). Discounted societal ICERs of tisagenlecleucel ranged between 31 682 EUR/QALY for Blina and 37 531 EUR/QALY for Clo-C and were considered cost-effective with a willingness-to-pay (WTP) threshold of 80 000 EUR/QALY. None of the scenarios exceeded this threshold, and more than 98% of the iterations in the probabilistic sensitivity analysis were cost-effective. Discussion: At the current price and WTP threshold, tisagenlecleucel is cost-effective from both a healthcare and a societal perspective. Nevertheless, long-term effectiveness data are needed to validate the several assumptions that were necessary for this model

Dynamical Chern-Simons modified gravity, Godel Universe and variable cosmological constant

We study the condition for the consistency of the G\"{o}del metric with the dynamical Chern-Simons modified gravity. It turns out to be that this compatibility can be achieved only if the cosmological constant is variable in the space.Comment: 8 pages, references adde

Many worlds in one

A generic prediction of inflation is that the thermalized region we inhabit is spatially infinite. Thus, it contains an infinite number of regions of the same size as our observable universe, which we shall denote as \O-regions. We argue that the number of possible histories which may take place inside of an \O-region, from the time of recombination up to the present time, is finite. Hence, there are an infinite number of \O-regions with identical histories up to the present, but which need not be identical in the future. Moreover, all histories which are not forbidden by conservation laws will occur in a finite fraction of all \O-regions. The ensemble of \O-regions is reminiscent of the ensemble of universes in the many-world picture of quantum mechanics. An important difference, however, is that other \O-regions are unquestionably real.Comment: 9 pages, 2 figures, comments and references adde

Combinatorial Alexander Duality -- a Short and Elementary Proof

Let X be a simplicial complex with the ground set V. Define its Alexander dual as a simplicial complex X* = {A \subset V: V \setminus A \notin X}. The combinatorial Alexander duality states that the i-th reduced homology group of X is isomorphic to the (|V|-i-3)-th reduced cohomology group of X* (over a given commutative ring R). We give a self-contained proof.Comment: 7 pages, 2 figure; v3: the sign function was simplifie